Medication of Diseases News - Part 4

The child’s mother, a certified nursing assistant, and aunt, a registered nurse, both of whom were certified in basic cardiopulmonary resuscitation (CPR), began performing two-person CPR, which they continued until the ground-based emergency medical services team arrived. The air ambulance also received a call at 12:13 pm and arrived at the scene at 12:45 pm. On arrival at the scene, the emergency medical technicians (EMTs) took over CPR and assigned the child a Glasgow coma scale score of 3, with no pupillary, no motor, and no verbal responses. The ground-based EMTs then thought they felt a weak pulse, and the child moved his arm. When the air ambulance EMTs arrived, they felt no palpable radial, carotid, or other pulse; his pupils were fixed and dilated; and they did not observe any other signs of life. CPR was continued in the air ambulance, and the child was intubated. As the patient did not have an IV line in place at that time, 0.1 mg of epinephrine 1:10,000 was administered via the endotracheal tube on five separate occasions, and 0.5 mg of atropine sulfate was administered on two occasions between 12:47 pm and 1:09 pm before a faint pulse and agonal respirations were noted. CPR was continued until arrival at the emergency department (ED), a distance of approximately 30 miles. canadian drug mall

In 1963, Kvittingen and Naess reported on a child in Norway who recovered after being submerged for 22 min in fresh water. Since then, a number of case reports have appeared in the literature reporting normal survival after submersion for substantial periods of time in cold water. For the most part, these cases have originated from Scandinavia, Canada, and the northernmost parts of the United States, with the victims falling through ice. To our knowledge, there has never been such a case report from a location with a more moderate climate such as Florida. We report the case of a 2-year-old (24 months) child who was found after being submerged for at least 20 min in a creek in rural Union County, FL, during an unusual brief period of cold weather, and who was resuscitated and survived without residual neurologic damage.

This study has several limitations. First, homelessness encompasses a broad range of people and conditions; the characteristics of persons who live on the streets are different from shelter residents or those living with family or friends. Therefore, health indicators, such as the prevalence of OLD, may vary by specific homeless group. This study focuses on one segment of the homeless population that may not be applicable to all homeless individuals, especially in that shelter residents may have better health or at least different degree of disease. However, a large proportion, if not the majority, of homeless people in the United States are staying in a shelter at least part of the time. Shelter residents are more likely to be homeless for the first time and homeless for < 6 months. This has important healthcare consequences, as long-term homeless (> 5 years) are less likely to report a site of care, and unsheltered homeless are more likely to abuse alcohol or drugs. Our finding of higher OLD in the shelter population raises the concern that the street population may have even a higher prevalence of OLD. asthma inhalers

Respiratory symptoms suggestive of OLD in our homeless sample were common. While respiratory symptoms related to infections have been well documented in the homeless, few studies evaluated symptoms possibly related to OLD. One study of marginally housed and street homeless male subjects compared to similar urban-housed male subjects found a higher rate of breathlessness in the homeless compared to the housed sample. Moreover, we found a high prevalence of self-reported OLD among the homeless, which was greater than that found in the general population of San Francisco County and the United States. my canadian pharmacy online

Despite the high prevalence of OLD among the homeless, few subjects received regular medical care for their respiratory condition. Among the 22 subjects who reported a physician diagnosis of asthma, chronic bronchitis, emphysema, or COPD, only 11 subjects (50%) indicated that they had at least one ambulatory medical visit for wheezing or dyspnea during the past 12 months. Similarly, a small proportion of homeless adults with OLD, as defined by spirometry, had an outpatient medical visit for respiratory symptoms (n = 10; 30%). Perhaps reflecting the low utilization of ambulatory medical care, the majority (60%) of homeless persons with OLD did not report a physician diagnosis of an airway disease (ie, asthma, chronic bronchitis, emphysema, or COPD). Moreover, only a small proportion of homeless with a self-reported diagnosis of airway disease or OLD (by spirometry) reported treatment with a respiratory medication during the past year (50% and 20%, respectively). canadian drug mall

Pulmonary function measurement among 67 homeless adults revealed a high prevalence of impairment (Table 4). The mean FEV1 was 2.80 L/s (SD 0.79), which was 85% predicted for the sample. However, the FEV1 range included some very low values (0.87 to 4.41 L/s), and 37% of the homeless subjects had a low FEV1 (< 80% predicted). The mean FVC was 3.74 L (SD 1.05), which was 91% predicted. The range of FVC also included some very low values (1.51 to 5.82 L), with 30% of homeless subjects having an FVC < 80% predicted. Mean FEVj/FVC ratio was 0.76 (SD 0.10), with 24% of subjects having a ratio < 0.70. canadian family pharmacy

The duration of the current period of homelessness was a mean of 42 months (SD 82) with 47% homeless < 1 year, 35% homeless 1 to 5 years, and 18% homeless > 5 years (Table 2). Almost one half had never been homeless before (28 subjects; 42%), one fourth had been homeless once before (18 subjects; 26%), one fourth had been homeless two to five times before (15 subjects; 22%), and the minority had been homeless more than five times before (6 subjects; 9%). Not considering the current night, the majority had spent some part of the last 30 days in a shelter (86%), followed by staying outside on the streets, in a car, or an abandoned business (40%), and in a single-occupancy hotel (22%).

Data were analyzed using statistical software (SAS Version 8.1; SAS Institute; Cary, NC). We used a multifaceted approach to define the prevalence of OLD among homeless adults based on symptoms, diagnosis, and pulmonary function. We calculated the prevalence of chronic respiratory symptoms, self-reported physician diagnosed OLD, and OLD based on the Global Initiative for Chronic Obstructive Lung Disease spirometric definition. The 95% confidence intervals (CIs) were calculated using the binomial distribution.
Because approximately half the sample was comprised of African-Americans, we used the x2 test to evaluate the impact of African-American race on the prevalence of chronic respiratory symptoms, self-reported physician-diagnosed OLD, pulmonary function impairment, and OLD based on pulmonary function. In addition, we present the pulmonary function results, including the prevalence of OLD, stratified by African-American race and other race/ethnicity. buy antibiotics online

Self-reported general health status was assessed using a question developed for the National Health Interview Survey and used in the Medical Outcomes Study Short Form-36, the most widely used generic health status measure. Respiratory symptoms in the past 12 months were evaluated by questions used in the National Health and Nutrition Examination Survey (NHANES) III: do you usually cough on most days for 3 consecutive months or more during the year, do you bring up phlegm or sputum or mucus on most days for 3 consecutive months or more during the year, have you had wheezing or whistling in your chest, and have you had any times when you had to stop for breath when walking about 100 yards or a few minutes on level ground? Based on these responses, we defined chronic bronchitis as affirmative responses to the cough and phlegm items. They were also asked if they had been told by a health-care professional that they had emphysema, chronic bronchitis, asthma, COPD, or any other lung problem. Other items from NHANES III were used to ascertain ambulatory medical visits and medications received for wheezing and dyspnea during the past 12 months. Finally, past and current use of cigarettes, cigars, and tobacco pipes was evaluated using questions from the National Health Interview Survey. contraceptive pills

Male subjects were randomly selected by shelter bed number to participate in the survey. For both sexes, shelter residents were ineligible if they were receiving medical treatment for active tuberculosis, had symptoms of active tuberculosis or an active pulmonary infection (fevers, chills, new or changed productive cough), were unable to complete survey (due to language barrier or poor mental status), or had chest or abdominal surgery in last 3 weeks. Written or verbal consent was obtained from all participants. The study was approved by the University of California, San Francisco Committee on Human Research. acular eye drops